Law Flashcards

Question

Prescription Labelling requirments

Answer 1

- Name of Patient - Name + Address of Pharmacy - Date of Dispensing - Name of Med + Quantity - Dosage Instructions - E.g. 500mg - 1 qd - Direction of Use - Cautionary Labels - RPS Recommendations - Keep out of site of children - Use only on skin when applicable etc

Answer 2

- When POM is dispensed MUST BE RECORDED - Exceptions = NHS Prescriptions = SHOULD NOT be entered in to Register - Good Practice = Enter P + GSL items - CD Meds = RECORD NEEDED

Answer 3

1. Date of Dispensing 2. Reason = e.g. Emergency Supply 3. Name + Address of Patient 4. Drug, Dosage, Form + Quantity + Prescription Instruction 1. E.g. 1 od 5. Name + Address of Prescriber 6. Date on RX 7. Date Prescription received

Answer 4

2 Years For CD Diff

Answer 5

1. Record on day of Supply or Next day 2. Record date of Supply 3. Record date on prescription 4. Medicine Name + Quantity + Formulation + Strength 5. Record Name + Address of Practitioner 6. Record Name + Address of Patient 7. NO Legal require to to include Dose but Good Practise 8. Record Price too

Answer 6

- - POM can be Supplied before receiving Prescription - Emergency Supply Requested by Prescriber - Prescriber must KNOW Pharmacist - Prescription sent within 72 hours - Medicine Supplied Per Instruction - Medicine NOT CD - Entry in Prescription Register

Answer 7

1. Record day or Supply or NEXT 2. Record date of Supply 3. Name (Strength + Form) + Quantity of Med supplied 4. Record Name + Address of Prescriber 5. Record date of Prescription 6. Record date Prescription received 7. Space left to include details when Script Arrives

Answer 8

- 1. Pharmacist personally interviews Patient 2. Pharmacist convictions clear + immediate need 3. Confirmation of Previous treatment + Dose 4. Limit Length of Treatment = Only give for how many days they need + take away that amount of tablets from Next prescription 5. Medicine NOT CD Sch 2 or 3 with exceptions 6. Entry made in POM Register

Answer 9

1. Record on day of Supply or Next 2. Record date of transaction 3. Name + Strength + Form + Quantity of Med Supplied 4. Record Name + Address of Patient 5. Record Nature of Emergency 1. Who ran out? 2. Who unable to obtain Rx? 3. Why they need it?

Answer 10

1. Ecstacy 2. Diamorphine / Heroin 3. LSD 4. Amphetamines 5. Methylphenidate 6. Cannabis 7. Midazolam 8. Pholcodine 9. Codeine 10. Morphine 11. Methadone 12. Nandrolone 13. Diazepam 14. Nabilone 15. Buphernophine 16. Phenobarbitalm

Answer 11

- By doctor for Patient on Px for Certain Conditions - MDS Controls Activities concerned with Dangerous Drugs = Covers Import, Export, Supply & Possession of Drug

Answer 12

- A = Most harmful = 7 Year Prison and/or Fine - E.g. Methadone, Heroin & Morphine ect - B = Less Harmful than A = 5 Year Prison - E.g. Phenobarbital + Cannabis ect - C = Less Harmful = 2 years Prison - E.g Benzodiazepines + Temazepam ect

Answer 13

- 3 Classes in Medicines + Divided into 5 Schedules - Methadone = S2 - Pholocodine = S5

Answer 14

All Drugs Controlled by Misuse of Drugs Act also Controlled by Human Medicines Regulations

Answer 15

- Hallucinogens like LSD, Ecstasy type Substances + Cannabis - Little to no therapeutic Value Cause Social Problems through Misuse - Not come across in Practise

Answer 16

- Includes Methadone, Diamorphine, Morphine, Pethidine, Oxycodone, Fentanyl + Methylphenidate - Strong Potential of Addiction - Illegal Value as Items of Commerce - Genius Medical Value - E.g. Methadone for Addicts - These Drugs may be supplied by Pharmacist to Patient Under Authority of Doctor - E.g. Diamorphine / Heroin for pain Relief in Terminally illness + Childbirth - Opiates act on receptor in Brain + Very addictive + Liable to misuse so regulated under MDS - Amphetamines Used to treat Narcolepsy = patient falls asleep during day without Warning + Hyperactivity in some children + PTSD - Drugs in this schedule are subject to strict controls in relation to Pxs, safe custody + Record keeping

Answer 17

1. Form required even if explicit from name e.g. MST 2. Strength of More than 1 Available 3. Liquid Preparation MUST be in ml 4. Dose as ‘One ad directed’ constitutes as a Dose 1. ‘As Directed’ = DOESN’T 5. Word “For Dental Treatment ONLY” = If Issues by Dentist 6. Total Quantity in Words + Figures 1. E.g. Thirty + 30 2. Pharmacist can add 2nd if one is present but other isn’t 1. Doctor Wrote 30 2. Pharmacist Writes Thirty

Answer 18

- Pethidine S2 ONLY in 50mg Tablets - If Rx says Pethidine Tablet Px Legally Valid as there is only 50mg available - MST = 5mg, 10mg, 15mg, 30mg, 60mg, 100mg, 200mg =0.2 g NEED to specific for RX to be Legal

Answer 19

1. MUST be stored in CD Cupboard under Lock + Key 1. Exemptions = Quinalbarbitone/Secobarbital 2. MUST comply with Strict Prescription Requirement 3. NO Emergency Supplies Permitted 4. Must be Dispensed within 28 days from date of Rx 5. Must RECORD in CD Register 6. Doctor can’t supply Over Phone in Emergency + Patient Can’t Request it = If do = NO 7. Private Rx Repeats = NOT ALLOWED 8. Private Prescription MUST be written in Standardised Form

Answer 20

- Prescriber ID Number in Private Px Form - Patient or Representative to Sign Back of Form - Pharmacist must Ascertain ID of Person Collecting - Private CD Form sent to Relevant NHS Agency

Answer 21

1. MUST be in Indelible INK = Ink that can’t be erased 2. MUST be entered on Day of Transaction Or NEXT day 3. MUST be in Chronological Order 4. NO Alterations = Mistake rectified with Annotations 5. Register MUST be Retained for 2 Years from Last Entry

Answer 22

1. Form + Strength of Preparation 2. Total Quantity in Words + Figure 1. Of either one written by Dr then other can be written by Pharmacist 3. Dose as ‘One ad directed’ constitutes as a Dose 1. ‘As Directed’ = DOESN’T 4. Word “For Dental Treatment ONLY” = If Issues by Dentist

Answer 23

1. Stored in CD cupboard under Lock + Key 2. Compliance with Strict Prescription Requirement 3. No Emergency Supplies Permitted EXCEPT Phenobarbital for Epilepsy 4. No Repeats 5. Dispensed in 28 days 6. If Private Px Repeat NOT ALLOWED 7. S3 CD = No Register Entry 8. ID of Patient Not needed 9. Private Px needs to be written on Standardised Form 10. Prescriber ID Number or Prescription Form 1. Private CD Form MUST be sent to NHS Business Service Authority

Answer 24

- Part 1 - CD Benz POM Contains most Benzodiazepines + Non Benzodiazepine Hypnotics + Sativex - Benzodiazepines (depression+ anxiety) = Diazepam, Nitrazepam, Lorazepam ect - Non Benzodiazepine Hypnotics = Zopiclone - Sativex = Cannabinoid oromucosal mouth spray - Part 11 - CD + POM Contains Anabolic Steroids (Treats Aplastic Anaemia) + Growth Hormones - POM Controls + Prescription Only Valid for 28 days - License needed to Import + Export CD Benz POM ( except personal self administration

Answer 25

- INV = Low Dose - Meds Contain Small amount of S2 CD - Kaolin + Morphine Mixture [P] - Co-Dryamol [POM] - Co-codamal 300/500 [POM] - If POM Px = Valid for 6 Months - Keep Invoice for 2 Years

Answer 26

- - Electronic Prescription Service - NHS Service sends Rx from Surgery → Pharmacy without paper copy

Answer 27

- More Convenient = Don’t have to return to surgery to pick up paper copy = Rx sent electronically - More choice when to get Meds = Rx can be sent to pharmacy near where you live, work or shop - Less wait - Better use of GP + Pharmacy time - Less Visits to collect paper Rx - Review Rx on screen = Easier - Clear Audit Trail

Answer 28

- Patient Choice - Patient may arrive at Pharmacy before Rx arrives - Discrepancy resolutions take longer

Answer 29

- - Any Patient - Patient with stable conditions - Patient who uses same pharmacy or already on online service

Answer 30

- - DONT have regular Prescription - Pick Meds from Diff Pharmacies each time

Answer 31

- 1. Supply Urgent Repeat Medicine through Referrals from NHS 111 2. Pharmacy receive NHS Referrals for Minor Illnesses through PharmOutcomes 3. Clinical Pathway Electronic Referrals from NHS 111, GP or other authorised Healthcare Provider = Also Self Referral 1. Can Supply POM for 7 Common Conditions

Answer 32

1. Acute otitis media 2. Impetigo 3. Infected insect bites 4. Shingles 5. Sinusitis 6. Sore throat 7. Uncomplicated UTI

Answer 33

- 1. Consultation with Patient 2. Decide to give advice or Sell/Supply Meds 3. Or Refer to GP or other Healthcare Professionals

Answer 34

- 1. May need to access National Care Record Service 2. Decide to Supply Med or Not 3. No CD S2 or S3 4. Pharmacist Paid to provide this service

Answer 35

“Instalment prescriptions covering more than one day should be collected on the specific day; if this collection is missed the remainder of the instalment less the amount prescribed for the day(s) missed may be supplied.

Answer 36

1. Comply with Requirement if CD S2 or S3 2. Specify num of Instalments + Quantity to be supplied for each 3. Intervals observed between Instalment ( taking weekend into account + when Pharmacy closed) 4. Max 14 day Supply 5. Instalment Amount + Dose Specify Separately ( Daily or few days) 6. 1st Instalment within 28 day of Prescription

Answer 37

- FP10MDA - CDs + CD S2 except Buprenorphine + Diazepam - Max 14 day supply = No Retrospective supply - Supplied to Representatives if agreed with patient + Pharmacist - 2 Pages - Page 1 = Prescription + other entry of details of Each supply - Page 2 = Details of each supply = Also entered into CD register if needed

Answer 38

PGD = Written directions relating to supply + administration of Medicine (POM or P) **PGDs allow specified health care professionals to supply and /or administer a medicine directly to a patient with an identified clinical condition without the need for a prescription or an instruction from a prescriber. The health care professional working within the PGD is responsible for assessing that the patient fits the criteria set out in the PGD **

Answer 39

Doctor or Dentist + Pharmacist

Answer 40

1. Period during which PGD will have effect 2. Description of Med to which PGD relates 3. And restriction in Quantity Supplied 4. Clinical Situations where POM or P Med used to treat 5. Criteria under which person Eligible for treatment 6. Detail who may be excluded from PGD 7. Cases when Further advice should be sought 8. Form can be Administered 9. Detail of Strength, Dosage, Route of Administration, Frequency, Min or Max Period of Use, Warnings, Follow up Action 10. Arrangement for Referral For advice 11. Details of Records to be Kept

Answer 41

- * To express willingness, Give Permission, Agree = Basic Right * Diff between Explicit + Implied Consent

Answer 42

Capacity + lack of outside pressure + sufficient information

Answer 43

Inability to make or communicate decision due to ‘impairment or disturbance’

Answer 44

- Specific at time of decision - Don’t make assumptions on age, Disability, belief, condition, behaviour, drugs or alcohol consumption, not the “correct belief”

Answer 45

- Explain consequences + Record - Respect Decision - OR Raise with others If believe there is a serious risk of harm

Answer 46

- Used for those who work with Children (Under 16) - Advice and/or treatment for Contraception + Sexual Health - ‘Gillick competent’ - Used more broadly to Assess

Answer 47

- Power Imbalance - Sexualised Behaviour - “Acts, words or behaviour designed to arouse or gratify sexual impulses or desire” - Breaching Boundaries - Revealing Intimate Personal Details - Giving or Accepting Social Invitations with Sexual Intent - Visiting Patient’s home without Consent with Sexual Intent - Meeting patients outside Normal Practise with Sexual Intent

Answer 48

- - Chaperones = For Patients + Professional’s Benefit - Cultural Differences - Personal Values + Belief = Respectful of Views - Previous Patient = Can still be Inappropriate but Consider All Factors - Raising Concern = Must Report Suspicions of Other Healthcare Professionals - Importance of Records of Possible Suspect Situations

Answer 49

- Duty of Confidentiality - Legal obligation around information obtained during Practise - Includes Electronic + Hard copy data, Personal Details, Medication, Medical History or Other Information - Does NOT include Anonymous, coded or Information already in Public Domain - Protecting Information = Take all Reasonable steps like Secure Storage, not discussing with others, Social Media policy + Team Responsibility - Disclosing Confidential Information = Decision Complex BUT Generally DONT Disclose Unless Special Limited Situation

Answer 50

- Make Sure individual understands all aspects - Consider Coding or Anonymising - Only Disclose Information needed - Indicate it in Confidential - Be Prepared to Justify any action taken - Record details - Need Explicit Consent if for Purpose a Patient would not reasonably expect

Answer 51

* ONLY need to do if court orders or in Public Interest * Ask for Written request for Disclosure * Check with Indemnity Insurance Provider, Regulator, Pharmacy Support Organisation or Independent Legal Advisor if appropriate

Answer 52

- Police or other law enforcement, prosecution or Regulatory Authority - Health Regulators e.g. GHPC, NHS counter fraud - Coroner or Judge or relevant court which orders info - Non Automatic Right to ALL Info = Check Reasoning - Check with Indemnity Insurance Provider, Regulator, Pharmacy Support Organisation or Independent Legal Advisor if appropriate

Answer 53

- Disclosure in Public Interest: - Serious Crime - Serious harm to Patient or 3rd Party - Check harm of Not Disclosing - Check with Indemnity Insurance Provider, Regulator, Pharmacy Support Organisation or Independent Legal Advisor if appropriate

Answer 54

- Professional responsibility to take action to protect Wellbeing of patient + Public - GPHC standards for Registered Pharmacist - Policy in place - Raising Concerns about individual Pharmacy professionals, the staff you work with (including trainees) employers + environment you work in is a key part of this - Includes Pharmacy colleagues + other people responsible for the care of patients, such as Carers, Care home staff + Key workers - Includes concerns about behaviours, competency, working environment + any actions that may compromise patient safety - Could be reluctant to raise concerns but Professional duty + legal obligation under Public Interest Disclosures Act 1998 - Failure to report concern could call into question own fitness to Practice - Find out employers policy - Report without delay to immediate supervisor, more senior manager or appropriate regulator - Keep record + maintain confidentiality

Answer 55

- Openness + Honesty, especially when things go wrong - Healthcare Professionals Must: - Tell patient (or where appropriate, patient advocate, carer or family when something is wrong - Apologise to patient ( or where appropriate patients advocate, carer or family) - Offer appropriate remedy or support to put matter right ( if possible) - Explain fully to Patient ( or where appropriate patients advocate,carer or family) Short + Long term effects of what has happened

Answer 56

- Certain belief may prevent pharmacists providing services e.g. abortion pills - Ensure Person-centered care not affected - If Service Requested then inform + direct patient why they may be able to get the service

Answer 57

1. Arrangement to secure Medicinal Products are in a safe + effective manner: 1. Ordered 2. Stored 3. Prepared 4. Sold by Retail 5. Supplied in Circumstances corresponding to retail sale 6. Delivered outside Pharmacy 7. Disposed of 2. Circumstances in which member of Pharmacy Staff who are not Pharmacist may give advice on medicinal Products 3. Identification of member of pharmacy staff who are, in view of responsible pharmacist, competent to perform specified tasks relating to Pharmacy business 4. Keeping Record about matters mentioned about ( in 1) 5. Arrangement which are to apply during absence of Responsible Pharmacist from the Premises 6. Steps to be taken when there is a change of Responsible Pharmacist at the premises 7. Procedure which is followed if a complaint is made about pharmacy business 8. Procedure which I is to be followed if an Incident occurs which may indicate that the Pharmacy buisness is not running in a safe + effective manner 9. Manner in which changes to the Pharmacy procedure are to be notified to the staff

Answer 58

- 1. Discharge Medicine Service 2. Dispensing of Appliances 3. Dispensing of Medicines 4. Disposal of unwanted Medicines 5. Health Living Pharmacies 6. Public Health (Promotion of Healthy Lifestyles) 7. Repeat Dispensing _ eRD Signposting 8. Support for self care 9. Discharge Medicine Service 10. Dispensing of Appliances 11. Dispensing of Medicines 12. Disposal of unwanted Medicines 13. Health Living Pharmacies 14. Public Health (Promotion of Healthy Lifestyles) 15. Repeat Dispensing _ eRD Signposting 16. Support for self care 17. Monitor May result in Withholding of Payment

Answer 59

- - Pharmacists can choose to provide any of the services as long as they meet requirements: 1. Appliance use Review 2. Flu Vaccination Service 3. Hypertension Case-Finding Service 4. LFD Service 5. New Medicine Service 6. Pharmacy Contraception 7. Pharmacy First Service 8. Smoking Cessation Service 9. Stoma Appliance `Customisation

Answer 60

- Detail linked to Pharmacy contract - Payment for Services - Tell Pharmacist what the NHS will pay them for - Tell Pharmacist how much the NHS will pay them - Tell Pharmacist how to get their money - Detail circumstances in which Certain Medication can be supplied or item can be classed as medicine - Update monthly as rules change - “Rule of game” - Someone players earn more = NHS Set total

Answer 61

- - Addiction, Misuse + Dependency - Sale of Medicines Protocol usually indicate how to recognise inappropriate requests = Large quantities or Frequent Purchases - Typical Requests - Pseudoephedrine - used to make crystal meth, Codeine linctus, Koalin + Morphine, Laxatives ( eating disorder), antihistamines or solvents - MHRA guidance - Distance selling of Meds to Public - Professional Responsibility to help requesters - How can we do this?

Answer 62

- - How can this be identified + What can be done? - Use Patient Medication Record (PMR) - Liaise with Prescriber to help Patients - Sulbutamonl Inhaler, Dihydrocodeine - Ensure Emergency Supply Request are conducted with the Patient + there in Immediate need - Drug Tariff: Part XIVA - Reward Scheme - Fraudulent Prescription - Proven - Conditions met - Forgery - £70 Reward - Prescriber self Medication or those with Close Personal Relation with - GPHC - ‘Pharmacists Prescribers Must non Prescribe for themselves or for anyone with who they have a Close personal Relationship (Such as family, friends, colleagues)

Answer 63

- - Supervised Self Administration of Methadone + Buprenorphine - Service Level Agreement - Clinical/Pharmacist agreement form - Needle Exchange - Paraphernalia, Citric Acid, Foil, Water for Injection